| NPI | 1306322466 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MD 06129) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2018-07-12 | 
| Last Update Date | 2020-10-01 |